Abstract
Objective
To quantify the Head Start (HS) teacher mediating and moderating influence on the effect of a wellness policy
intervention.
Design
Intervention trial within a larger randomized community trial.
Setting
HS preschools in Hawaii.
Participants
Twenty-three HS classrooms located within 2 previously randomized communities.
Intervention
Seven-month multi-component intervention with policy changes to food served and service
style, initiatives for employee wellness, classroom activities for preschoolers promoting
physical activity (PA) and healthy eating, and training and technical assistance.
Main Outcome Measures
The Environment and Policy Assessment and Observation (EPAO) classroom scores and teacher questionnaires assessing on knowledge, beliefs,
priorities, and misconceptions around child nutrition and changes in personal health
behaviors and status were the main outcome measures.
Analysis
Paired t tests and linear regression analysis tested the intervention effects on the classroom
and mediating and moderating effects of the teacher variables on the classroom environment.
Results
General linear model test showed greater intervention effect on the EPAO score where
teachers reported higher than average improvements in their own health status and
behaviors (estimate [SE] = −2.47 (0.78), P < .05).
Conclusions and Implications
Strategies to improve teacher health status and behaviors included in a multi-component
policy intervention aimed at child obesity prevention may produce a greater effect
on classroom environments.
Key Words
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Article info
Publication history
Accepted:
February 21,
2016
Footnotes
Conflict of Interest Disclosures: The authors’ conflict of interest disclosures can be found online with this article on www.jneb.org.
Identification
Copyright
© 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
